Generating Virtual Short Tau Inversion Recovery (STIR) Images from T1- and T2-Weighted Images Using a Conditional Generative Adversarial Network in Spine Imaging

Short tau inversion recovery (STIR) sequences are frequently used in magnetic resonance imaging (MRI) of the spine. However, STIR sequences require a significant amount of scanning time. The purpose of the present study was to generate virtual STIR (vSTIR) images from non-contrast, non-fat-suppressed T1- and T2-weighted images using a conditional generative adversarial network (cGAN). The training dataset comprised 612 studies from 514 patients, and the validation dataset comprised 141 studies from 133 patients. For validation, 100 original STIR and respective vSTIR series were presented to six senior radiologists (blinded for the STIR type) in independent A/B-testing sessions. Additionally, for 141 real or vSTIR sequences, the testers were required to produce a structured report of 15 different findings. In the A/B-test, most testers could not reliably identify the real STIR (mean error of tester 1–6: 41%; 44%; 58%; 48%; 39%; 45%). In the evaluation of the structured reports, vSTIR was equivalent to real STIR in 13 of 15 categories. In the category of the number of STIR hyperintense vertebral bodies (p = 0.08) and in the diagnosis of bone metastases (p = 0.055), the vSTIR was only slightly insignificantly equivalent. By virtually generating STIR images of diagnostic quality from T1- and T2-weighted images using a cGAN, one can shorten examination times and increase throughput.